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Building resilience to help you manage your chronic pain

If a scroll through your social media feed or a quick look at your favourite news outlet each morning triggers sweaty palms, a racing heart, and other feelings of panic, you are not alone. The stress in our country is overwhelming, and often as a result our mental health does to. Though physical health is a top concern as we anxiously check for news on containment of COVID-19, we’re also worrying about job loss, financial fallout, school closures, grief, and uncertainty about what the future holds.

An article published April 10 in JAMA Internal Medicine cautions that although the literature on the mental health consequences of epidemics is sparse, large-scale disasters are often associated with increases in post-traumatic stress disorder (PTSD), substance use disorder, a broad range of mental health disorders (including anxiety and depression), domestic violence, and child abuse.

Given wide-scale orders for sheltering in place, social distancing, and school and work closures, people of all ages are at risk for loneliness, stress, anxiety, depression, and increased substance abuse.

As isolation and disruption to normal daily routines continues, you can expect shifting emotions, feelings of irritability, feelings of disconnection, and other signs of stress and anxiety. There is no easy way through this crisis but building coping skills and resilience will help you work through the emotional upheaval triggered by COVID-19.

Resilience is the process of adapting in the face of adversity, trauma, tragedy, or other significant sources of stress. Becoming resilient helps you work through difficult events, but it also helps you grow and improve your life even in the absence of adversity. Some people refer to resilience as “bouncing back,” but it’s more than that. Being resilient includes learning from past experiences and developing new coping strategies moving forward.

Understanding Stress Symptoms

The Centers for Disease Control and Prevention (CDC) has warned that the outbreak of COVID-19 can be especially stressful for vulnerable populations, including older adults, children, healthcare workers and first responders, and people with existing mental health problems and substance abuse. The tricky thing about stress is that symptoms can vary among age groups and individuals.

Here are some common symptoms of stress in different age groups.

Signs of Stress in Older Adults

  • Feeling tired
  • Sleeplessness
  • Digestive issues
  • Irritability
  • Frequent worrying
  • Headaches and other pains
  • Frequent crying
  • Shortness of breath
  • Fear about health and safety

Signs of Stress in Adults

  • Lethargy
  • Headaches
  • Upset stomach
  • Insomnia
  • Muscle aches
  • Chest pains and rapid heartbeat
  • Frequent illness
  • Loss of sexual desire
  • Low self-esteem
  • Nervousness
  • Difficulty relaxing
  • Agitation
  • Feeling overwhelmed

Signs of Stress in Children and Teens

  • Psychosomatic complaints (headaches, stomachaches, muscle aches)
  • Sleep disturbance (difficulty falling or staying asleep)
  • Nightmares or night terrors
  • Irritability
  • Regressed behaviour (including bedwetting)
  • Acting out (teens)
  • Anger (teens)
  • Avoiding schoolwork
  • Excessive worry or sadness
  • Aggressive behaviourr
  • Use of alcohol, tobacco, or other drugs (teens)
  • Changes in eating habits

Key Steps to Building Resilience 

Like building a muscle, increasing your resilience requires time and dedication. If you don’t put in the work, it might atrophy. People are conditioned to think of resilience as a personality trait (either you have it or you don’t), but this isn’t the case. With intention and practice, you can become more resilient, no matter your age.

There isn’t one specific strategy to use to build resilience. It’s a process of establishing connections, coping with stress, adjusting your thought process, and fostering physical wellness.

Step 1: Build Your Connections

We all need support in life, not just in a crisis. Building a support network of empathetic and compassionate people helps you feel less alone in times of need. Different age groups may try different approaches.

Older adults Some older adults are comfortable with technoIf this is the case, many churches, synagogues, and other religious houses of worship are livestreaming services and creating groups on platforms like Zoom. Book groups or other social clubs can also move to Zoom or other online platforms. Video chats with friends and family can help with those connections. If older adults are not comfortable with technology, phone calls and letters are essential.

Adults Juggling working from home, handling finances, parenting, and distance learning is difficult and doesn’t leave a lot of time for connecting with other adults. This is particularly true for first responders and other essential workers working long hours to combat this crisis. Make time for video chats to “see” other people and join virtual meetups when you can. While the exhaustion of stress might trick you into thinking that isolating yourself is best, feeling supported by your friends will help you through this difficult time.

Children and teens Balance is always important, but now is the time to err on the side of allowing more digital connections so kids can maintain friendships. Some parental supervision may still be necessary, but all age groups can benefit from connecting with friends, family, and classmates they haven’t been able to see in person for a while.

Step 2: Learn Coping Skills

We all need to hone our coping skills during this crisis so that we can work through the emotional shifts we are likely to experience in an adaptive way. There are a few coping strategies that tend to work across age groups.

Deep breathing Deep breathing helps calm the central nervous system and works whether you’re experiencing symptoms of panic or general discomfort. Try square breathing: Trace a square in your palm and count as you draw each line: Inhale, two, three, four; hold, two, three, four; exhale, two, three, four; hold, two, three, four.

Meditation and visualization A number of apps can assist with getting into the habit of clearing your mind of stress and visualizing positive outcomes, such as Calm for adults and teens, and Stop, Breathe, Think Kids for little ones.

Exercise Daily exercise is a natural stress reliever. Get out for walks or try a livestream exercise class.

Step 3: Adjust Your Thought Process

It’s difficult to maintain an optimistic outlook when the future feels so uncertain, but positive thinking will help you focus on hope and visualize better times ahead. When you feel flooded with negative thoughts, own them. When you say your thoughts out loud and talk through them, they lose their power.

State your negative thought, think about where it stems from, and offer three positive alternative thoughts. Everyone from older adults to very young children can learn to do this.

Step 4: Focus on Physical Wellness

Stress can hobble your immune system and make you more susceptible to illness. This can, in turn, negatively affect your emotional state. Maintaining your physical wellness plays an important role in building resilience.

When you take a whole-person approach to self-care, you care for both your body and your mind. Get back to basics to get into the habit of self-care:

  • Prioritize sleep According to the National Sleep Foundation, people have different sleep needs at different ages, but sleep is universally affected when you’re under stress, regardless of your age. Older adults tend to log fewer hours at night (7 to 8 hours), but may need a nap during the day. Adults need 7 to 9 hours, teens need 8 to 10, and children need 9 to 11. Be sure to maintain a consistent sleep schedule during this time.
  • Focus on healthy eating If you crave salty or sweet foods when you’re under stress, you’re not alone. Many people want comfort food in times of crisis; but balanced, healthy eating is best for your physical health. Plan ahead for a steady rotation of nutritious meals.
  • Maintain hydration Believe it or not, dehydration can exacerbate symptoms of stress. Be sure to drink plenty of water throughout the day.
  • Remain active In addition to daily exercise, do fun or mentally stimulating activities to enrich your mind and spirit. Play an online card game with a friend or family member, work on a puzzle, spend time gardening, or find another hobby or skill that engages your whole self.

You can take small steps each day to build your resilience muscles, and this will help you through this crisis as well as any future adversity.

Resilience, defined as the ability to adapt in a positive way in the presence of adversity, has been a topic of great interest for some time now, particularly within psychology. As countless studies show, resilience is a critical skill for reducing and managing stress and responding to emotional challenges, including traumatic life events. It’s what allows us to recover from difficulties and setbacks. If, as Nietzsche famously noted, what doesn’t kill you makes you stronger, then you can thank resilience.

Get more sleep

Sleep has been found to enhance resilience. Although stress and anxiety deteriorate sleep quality, sleep is more controllable than we think. It’s certainly easier to master than mediation. Being disciplined, going to sleep earlier, cutting down on TV time (particularly consuming morbid or negative news), exercising more, drinking less, and eating healthier, including earlier dinner time (allowing for better digestion), will improve your typical sleep quality. For more information try https://sleepwellwithdrsue.com

Find meaning

Unsurprisingly, resilience tends to increase when people have a sense of purpose. One of the most famous case studies for this was provided by Viktor Frankl’s gruesome account of his experience in a concentration camp during WWII. As he notes in Man’s Search of Meaning: “In a position of utter desolation, when man cannot express himself in positive action, when his only achievement may consist in enduring his sufferings in the right way–an honorable way–in such a position man can, through loving contemplation of the image he carries of his beloved, achieve fulfillment.” That fulfillment comes from finding meaning. As Charles Bukowski, who was arguably at the opposite positivity pole from Viktor Frankl, famously noted: “Find a passion and let it kill you.”

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